Healthcare Provider Details

I. General information

NPI: 1619113008
Provider Name (Legal Business Name): PFISTER PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2009
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 2ND ST E STE 102
WHITEFISH MT
59937-2447
US

IV. Provider business mailing address

214 2ND ST E STE 102
WHITEFISH MT
59937-2447
US

V. Phone/Fax

Practice location:
  • Phone: 406-730-2224
  • Fax: 406-730-2228
Mailing address:
  • Phone: 406-730-2224
  • Fax: 406-730-2228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPTP-PT-LIC-6099
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRIAN LEE HARMS
Title or Position: BILLING/ADMIN
Credential:
Phone: 406-407-1231